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Gastrointestinal bleeding after liver transplantation
J Tabasco-Minguillán1, A Jain, M Naik
1Division of Transplantation Medicine, University of Pittsburgh Medical Center, Pennsylvania 15213, USA.
Transplantation
|January 15, 1997
Summary
Gastrointestinal bleeding (GIB) after liver transplantation (OLTx) occurred in 8.9% of patients, with ulcers being the most common cause. GIB significantly reduced patient and graft survival rates post-OLTx.
Area of Science:
- Hepatology
- Gastroenterology
- Transplantation Surgery
Background:
- Gastrointestinal bleeding (GIB) is a potential complication following orthotopic liver transplantation (OLTx).
- Understanding the incidence, causes, and impact of GIB is crucial for improving outcomes in OLTx recipients.
Purpose of the Study:
- To determine the incidence and causes of GIB after OLTx.
- To evaluate the effect of GIB on patient and graft survival following OLTx.
Main Methods:
- A retrospective study of 1000 consecutive OLTx patients treated with tacrolimus.
- Analysis of 74 patients with GIB and comparison with 760 patients without GIB.
- Endoscopic evaluation for diagnosis of GIB sources.
Main Results:
- The cumulative incidence of GIB was 8.9%.
- Ulcers were the most frequent cause of GIB (25/92 episodes), followed by enteritis and portal hypertensive lesions.
- GIB episodes predominantly occurred within the first postoperative trimester (73%).
- Patients experiencing GIB had statistically lower patient and graft survival rates compared to controls.
Conclusions:
- Gastrointestinal bleeding after OLTx is associated with significantly decreased patient and graft survival.
- Endoscopy is effective in identifying the source of GIB in most cases.
- Early identification and management of GIB are critical for improving outcomes in liver transplant recipients.
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